Falls InjuryNCT07536035
Potential of Interface Care Models to Deliver More Appropriate Care to Patients With Acute Medical Illness
An observational study of Falls Injury and Falls, run by National University Hospital, Singapore at 1 site in Singapore.
Trial summary
Every country in the world is experiencing growth in both the size and the proportion of older persons. As a result of the changes, the profile and needs of people with medical illnesses have evolved. Read more about this study
- Who is it for?
- Ages 21 years and older
- Conditions the study is for
- Falls Injury, Falls, Hospitalization in Acute Care
- How many people
- 220 participants
- Where
- 1 siteSingapore
- Study dates
- 30 Sep 2024to 31 May 2026
- Phase
- Observational
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 21 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: The study population will consist of adult patients admitted to the National University Hospital (NUH), Singapore, for acute medical conditions. Participants will be recruited either from the Acute Medical Unit (AMU) or directly to the General Ward (GW) following presentation to the Emergency Department. Patients represent a typical mix of acute medical admissions seen in a tertiary hospital setting, including infection-related illnesses, falls with disequilibrium, and acute exacerbations of chronic diseases such as Chronic Obstructive Pulmonary Disease (COPD).
Who may be able to join
- AMU inclusion criteria - admission from ED to AMU directly
- Control group inclusion criteria - admission from ED to GW directly
- Acute medical illnesses that includes infection-related conditions, falls-disequilibrium, and acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD).
Who cannot join
- Below 21 years old
- Patients undergoing active chemotherapy
- Patients with active pregnancy
- Patients admitted less than 24 hours
- Cerebrovascular disease requiring thrombolysis or intravascular intervention
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Singapore1 site, 1 recruiting
- Recruiting
National University Hospital
Singapore, 119228
John TY Soong, PhD, +6567727678, John_soong@nuhs.edu.sg
John TY Soong, PhD
About this study
Official title: Potential of Interface Care Models to Deliver More Appropriate Care to Patients With Acute Medical Illness in Singapore and Decrease Utilisation of Acute Care Bed-days
Every country in the world is experiencing growth in both the size and the proportion of older persons. As a result of the changes, the profile and needs of people with medical illnesses have evolved. How care is delivered to patients has to keep pace with these changes, or patients will experience poor care at high cost and not have their needs met. A new model of care has emerged to meet these challenges: Acute Medical Unit. Despite considerable investment and popularity of this model, questions remain: (i) Who benefits most from this care model? (ii) How may these models be most effectively implemented for the best results? (iii) How effective are these models? Singapore is well-placed to answer these questions with its national healthcare system and excellent research institutions. The investigators plan to study how effective the model is by comparing patients with similar profiles exposed to both these care models compared to how hospital care is usually provided, looking for four differences: (i) how long patients stay in hospital, (ii) how often they use the emergency department (iii) quality of health (iv) cost. Additionally, the investigators seek to characterise patterns of health needs for this group of patients.
- Conditions
- Falls Injury, Falls, Hospitalization in Acute Care, Chronic Obstructive Pulmonary Disease (COPD), Infection, Acute Exacerbation of Asthma
- Keywords
- Acute Medical Unit, Acute Medicine, Interface Care, Clinical effectiveness, Cost effectiveness, prospective observational, matched controlled
- Medical subject headings
- Pulmonary Disease, Chronic Obstructive, Infections, Pneumonia, Urinary Tract Infections
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Acute Medical Unit (AMU) Patients | Patients admitted to the AMU from the Emergency Department (ED) or specialist clinics as their first admission ward. The AMU provides rapid assessment and early intervention to improve efficiency of care. Participants will primarily include adults with acute medical illnesses such as infection-related conditions, falls/disequilibrium, or acute exacerbation of COPD. | |
| General Ward (GW) Control Patients | Patients admitted directly from the ED to General Wards under the Division of Advanced Internal Medicine. Patients will be matched to the AMU group by diagnosis group, age, gender, illness severity, comorbidities, frailty, and functional status to minimize confounding factors. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean acute care bed-days utilised
Average total days of acute hospital stay, including the index episode, for each patient. Measures efficiency of hospital care between AMU and GW groups.
Measured: Up to 6 months following discharge
Secondary outcomes (9)
Patient Outcomes - Health-related Quality of Life (EQ-5D-5L)
Patients rate 5 areas - mobility, self-care, usual activities, pain/discomfort, and anxiety/depression on a 5-level scale from 1 (no problems) to 5 (extreme problems). Scores are combined into an overall health index, where higher scores indicate worse health status. This captures the patient's overall quality of life over the follow-up period.
Measured: Baseline (Day 0, at discharge), 3 months post-discharge, and 6 months post-discharge
Patient Outcomes - Patient Activation Measure (PAM-13)
Patients answer 13 questions on a 4-point scale from "strongly disagree" to "strongly agree," with a "not applicable" option. Raw scores are converted to a 0-100 scale, where higher scores indicate greater engagement in self-care. Scores classify patients into four levels: Level 1 = disengaged, Level 2 = gaining confidence, Level 3 = taking action, Level 4 = confident and maintaining self-management.
Measured: Baseline (Day 0, at discharge) and 6 months post-discharge
Patient Outcomes - World Health Organisation Five Wellbeing (WHO-5)
Patient answers five questions that assess mood, energy, and interest in daily life over the past two weeks, scored 0 (at no time) to 5 (all of the time). The total score (0-25) is multiplied by 4 to create a 0-100 scale, where higher scores indicate better wellbeing.
Measured: Baseline (Day 0, at discharge), 3 months post-discharge, and 6 months post-discharge
Patient Outcomes - Patient Health Questionnaire (PHQ-9)
PHQ-9 includes 9 items scored 0 (not at all) to 3 (nearly every day), total 0-27; higher scores indicate more severe depressive symptoms.
Measured: Baseline (Day 0, at discharge) and 6 months post-discharge
Patient Outcomes - Functional Dependence (Barthel Index)
Measures independence in 10 daily activities, scored 0 (fully dependent) to 100 (fully independent). Higher scores indicate greater ability to perform daily activities without assistance.
Measured: Baseline (Day 0, at discharge) and 6 months post-discharge
System Outcomes - Number of Emergency Department (ED) visits
Number of ED visits recorded in hospital records within 6 months. Higher counts reflect greater acute care needs.
Measured: Baseline (Day 0, at discharge) and 6 months post-discharge
System Outcomes - Specialist Outpatient Clinic visit
Number of outpatient specialist visits, as recorded in hospital system.
Measured: Baseline (Day 0, at discharge) and 6 months post-discharge
System Outcomes - Polyclinic Visits
Number of visits to public polyclinics captured through health records
Measured: Baseline (Day 0, at discharge) and 6 months post-discharge
System Outcomes - Hospital Admissions
Number of inpatient hospital admissions during follow-up, excluding the index admission.
Measured: 6 months post-discharge
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Apr 2026
- Study start30 Sep 2024
- Primary completion31 May 2026 (estimated)
- Study completion31 May 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for Falls InjuryStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 220 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National University Hospital, Singapore
- Sponsor type
- University, hospital or other
- Collaborators
- Duke-NUS Graduate Medical School
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07536035
- Sponsor's protocol ID
- MOH-001435-00
- Status last verified
- Sep 2025
- First submitted
- 25 Jan 2026
- Last updated
- 17 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided: At the time of study planning, no identified repository existed for this data. Researchers are welcome to contact the Principal Investigator directly.
Publications
Lateef A, Lee SH, Fisher DA, Goh WP, Han HF, Segara UC, Sim TB, Mahadehvan M, Goh KT, Cheah N, Lim AYT, Phan PH, Merchant RA. Impact of inpatient Care in Emergency Department on outcomes: a quasi-experimental cohort study. BMC Health Serv Res. 2017 Aug 14;17(1):555. doi: 10.1186/s12913-017-2491-x.
PubMed 28806942Balakrishnan T, Teo PSE, Lim WT, Xin XH, Yuen BH, Wong KS. Acute Medical Ward for better care coordination of patients admitted with infection - evidence from a tertiary hospital in Singapore. Acute Med. 2017;16(4):170-176.
PubMed 29300795Reid LE, Dinesen LC, Jones MC, Morrison ZJ, Weir CJ, Lone NI. The effectiveness and variation of acute medical units: a systematic review. Int J Qual Health Care. 2016 Sep;28(4):433-46. doi: 10.1093/intqhc/mzw056. Epub 2016 Jun 16.
PubMed 27313174Soong JTY, Bell D, Ong MEH. Meeting today's healthcare needs: Medicine at the interface. Ann Acad Med Singap. 2022 Dec;51(12):787-792. doi: 10.47102/annals-acadmedsg.2022196.
PubMed 36592147Roseveare C. Acute medicine and general practice: a key interface in managing emergency care pressures. Br J Gen Pract. 2014 Mar;64(620):122-3. doi: 10.3399/bjgp14X677392. No abstract available.
PubMed 24567628Soong JTY, Valderas JM, Bell D, Ghandi M, Graves N, Ong M. Clinical and cost-effectiveness of an acute medical unit model in Singapore: protocol for a pilot prospective cohort study. BMJ Open. 2026 Jul 27;16(7):e121444. doi: 10.1136/bmjopen-2026-121444.
PubMed 42509004